Minor head injury and concussion

What is minor head injury/concussion?

Minor head injury - also known as concussion - is commonly caused by falls, road crashes, assaults and sports accidents. It is estimated that over a million people each year attend accident and emergency departments in the UK after a head injury, with the majority of these injuries being classed as minor.

The effects of minor head injury/concussion can leave people with symptoms including dizziness, nausea, confusion or an inability to process or retain information, sensitivity to light, and vision distortion.

Minor head injury is defined by:

Loss of consciousness of less than 30 minutes (or no loss of consciousness)

Post-traumatic amnesia (PTA) of less than 24 hours after injury (this is a period where people are confused, act strangely and are unable to remember what has just happened)

It is important to note that only around 10% of reported minor head injuries/concussions involve a loss of consciousness – so it’s important to not solely rely on this as an indicator.

When should I seek medical advice after minor head injury/concussion?

After a minor head injury/concussion, it is important that, if possible, you are accompanied by a responsible adult.

While unlikely, there is a small risk of developing complications, so if you experience any of the following symptoms in the next few days you should go to your nearest Emergency Department as soon as possible:

Loss of consciousness

Increasing disorientation

New deafness in one or both ears

Problems understanding or speaking

Loss of balance or problems walking

Blurred or double vision

Any weakness in one or both arms or legs

Inability to be woken

Any vomiting

Bleeding from one or both ears

Clear fluid coming out of your ears or nose

Any fits (collapsing or passing out suddenly)

Drowsiness when you would normally be wide awake

Severe headache not relieved by painkillers such as paracetamol

Dos and don'ts in the first few days after injury

DO make sure you stay within reach of a telephone and medical help in the next few days

DO have plenty of rest and avoid stressful situations

DO show this factsheet to a friend or family member who can keep an eye on your condition

DO take painkillers such as paracetamol for headaches

DON'T stay at home alone for 48 hours after leaving hospital

DON'T drink alcohol until you feel better

DON'T take aspirin or sleeping tablets without consulting a doctor

DON'T return to work until you feel ready

DON'T play any contact sport for at least three weeks without consulting your doctor

DON'T return to driving until you feel you have recovered. If in doubt consult your doctor.

Post-concussion syndrome

The effects of a minor head injury can be anything but minor to the person concerned. They can include nausea, headaches, dizziness, impaired concentration, memory problems, extreme tiredness, intolerance to light and noise, and can lead to anxiety and depression. When problems like this persist, they are often called post-concussion syndrome.

What are the symptoms of post-concussion syndrome?

The symptoms of post-concussion syndrome may include:

Headaches

Irritability

Feelings of dizziness

Restlessness

Nausea

Impulsivity and self-control problems

Sensitivity to light

Difficulties with concentration

Sensitivity to noise

Feeling depressed, tearful, anxious

Sleep disturbance

Fatigue

Memory problems

Difficulties thinking and problem-solving

How long does post-concussion syndrome last?

In many cases these symptoms resolve themselves within a few days or weeks. However, in some cases problems can persist for months, but still resolve themselves eventually. This can be a frustrating time, as the effects may be subtle and you may not have been told about them.

This may also be the most prolonged period of feeling ill that you have experienced and you may wonder if you will ever feel better. Following the suggestions in our booklet Minor head injury and concussion (PDF) should help to make you feel better as quickly as possible, but be patient with yourself and try not to rush things.

It is important to realise that these symptoms often happen even when there is no damage to the brain and that the fear of having brain injury, even if there is none, can be very distressing and can delay recovery. So it is sensible, if you have these symptoms for more than about two weeks after the injury, or if they are severe and not getting any better, that you see your GP.

It may be appropriate to be referred to a head injury specialist, such as a neurologist or neuropsychologist, for assessment.

Managing concussion

It is important that relatives and employers are warned about the possible effects of a minor head injury, and for plans to be made accordingly. These might include not rushing to return to work, keeping stress to a minimum in the short term, and abstaining from alcohol.

One study showed that almost one third of people with a minor head injury were not working full-time three months after receiving the injury, although other studies have been much more optimistic. Difficulties are certainly made much worse if the person has a mentally demanding job where there is a low margin for error.

Concussion in sport

As with in life in general, accidents and collisions can occur in contact sports – with head injuries commonplace in sports such as football, rugby, hockey and many others. And while rules are in place in such sports to protect players from head injuries, collisions are inevitable in contact sports.

Visit our Concussion in sportcampaign page for more information on concussion in sport, including expert opinions, useful downloads, and information on what to do should you suspect concussion.

Recovery and further information

The general conclusion seems to be that the vast majority of people who experience a minor head injury make a full recovery, usually after 3-4 months. However there is a very small sub-group whose recovery is not so good.

Headway - the brain injury association is registered with the Charity Commission for England and Wales (Charity no. 1025852) and the Office of the Scottish Regulator (Charity no. SC 039992). Headway is a company limited by guarantee, registered in England no. 2346893.